Fall 2026

Following Dobbs v. Jackson Women’s Health Organization, the ACGME’s abortion training standards face growing tensions with state laws and the conscience rights of physicians and institutions. This article examines these conflicts through bioethical principles and virtue ethics, arguing that medical education should cultivate both clinical competence and professional integrity. It proposes four reforms: separating federal graduate medical education funding from abortion training, aligning requirements with state laws, protecting conscience-based institutional exemptions, and adopting an opt-in framework for trainees. Through alternative training pathways, these proposals seek to maintain educational rigor while respecting moral convictions and legal restrictions, supporting a more ethically pluralistic approach to medical education.

Mifepristone was first approved in 2000 in conjunction with misoprostol to induce abortion, and both its initial approval and subsequent regulation have been controversial. In 2021, the Food and Drug Administration (FDA) undertook a full review of the mifepristone Risk Evaluation and Mitigation Strategy (REMS) program, with the aim of assessing the necessity of each of the three Elements to Assure Safe Use (ETASUs) present in the mifepristone REMS, including ETASU C, the “in-person dispensing requirement.” Following this review, the FDA concluded that ETASU C could be safely removed and that mifepristone could be safely dispensed outside of the previously approved settings. This paper seeks to critically analyze the 2021 REMS Review, as well as the studies cited therein to determine whether the evidence presented by the FDA sufficiently substantiated this decision.